My Child Has a Cavity. Now What?
Finding a cavity does not automatically mean extensive treatment.
The best treatment depends on the size, depth, and location of the cavity.
Early diagnosis gives us more treatment options and often allows us to use less invasive approaches.
Very Small Cavities
When a cavity is detected early, treatment may be possible without traditional drilling.
Silver Diamine Fluoride (SDF)
SDF is a liquid medication that can help stop active cavities from progressing.
Benefits include:
No drilling
No injections
Quick application
Helpful for very young children or certain high-risk patients
One important consideration is that SDF can darken the treated cavity, indicating that the decay has been arrested.
Curodont®
For carefully selected early lesions, Curodont may help promote natural repair of weakened enamel before a larger cavity develops.
This minimally invasive treatment can sometimes help preserve healthy tooth structure and delay or avoid more extensive treatment.
Small Composite Fillings
When a cavity has progressed beyond the earliest stages, a small tooth-colored filling may be recommended.
The damaged area is removed, and the tooth is restored with a durable tooth-colored material.
Medium-Sized Cavities
As cavities grow, more tooth structure becomes affected.
These teeth often require:
A larger filling
Additional support to protect the tooth
In some cases, a protective pulp liner may be placed to help shield the dental nerve and promote long-term tooth health.
Large Cavities
When decay affects a substantial portion of the tooth, a regular filling may no longer be strong enough.
Stainless Steel Crowns (SSC)
Pediatric dentists commonly recommend stainless steel crowns for baby teeth with extensive decay.
Benefits include:
Excellent durability
Full coverage protection
Reduced risk of future fracture
Better long-term success for heavily damaged teeth
Pulpotomy
If the cavity approaches or reaches the nerve tissue, a pulpotomy may be required.
Commonly referred to as a "baby root canal," this procedure removes unhealthy tissue from inside the crown portion of the tooth while preserving the remaining healthy root structure.
A stainless steel crown is often placed afterward to protect the tooth.
Very Large Cavities
Unfortunately, some cavities become too large to repair predictably.
When the remaining tooth structure cannot be restored safely, extraction may be the healthiest option.
If a baby tooth is removed early, space maintenance may sometimes be recommended to help permanent teeth erupt properly.
What Happens If Cavities Are Left Untreated?
Cavities do not heal on their own.
A small cavity usually becomes larger with time.
As the cavity progresses:
Enamel is damaged.
Decay spreads deeper into the tooth.
The nerve may become inflamed or infected.
Pain and infection can develop.
More complex treatment may become necessary.
Early treatment is almost always the simplest treatment.
Dental Infections in Children
One of the most important things parents should understand is that dental infections do not always cause pain immediately.
Many children with infected teeth continue eating, playing, and acting normally.
Stage 1: Silent Infection
As bacteria reach the nerve, infection can begin within the tooth.
At this stage:
Symptoms may be minimal
The child may have no complaints
The problem may only be visible on an X-ray
Stage 2: Gum "Pimple"
As infection spreads beyond the tooth, a small bump may appear on the gums.
Parents may notice:
A white or yellow bump
Drainage
Bad taste or odor
This "pimple" is often a sign that infection is draining through the gums.
Stage 3: Localized Swelling
The infection may eventually overwhelm the body's ability to drain it.
Parents may notice:
Swelling near a tooth
Redness
Tenderness
Increased discomfort
Stage 4: Facial Swelling
If infection continues to spread, facial swelling can develop.
This may involve:
Cheek swelling
Lip swelling
Jaw swelling
Fever
Difficulty eating
Facial swelling resulting from a dental infection should be evaluated promptly because infections can spread and may require urgent treatment.